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|本期目录/Table of Contents|

国产封堵器治疗房间隔缺损的应用(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第6期
页码:
583-585
栏目:
临床研究
出版日期:
2005-12-05

文章信息/Info

Title:
Percutaneous transcatheter closure of atrial septal defect using domestic septal occluder
作者:
方臻飞1; 沈向前1; 周胜华1; 胡信群1; 高梅2; 祁述善1; 吕小玲1
中南大学湘雅二医院：1.心内科，2.超声科，湖南 长沙 410011
Author(s):
FANG Zhenfei1;  SHEN Xiangqian1;  ZHOU Shenghua1;  HU Xinqun1;  GAO Mei2;  QI Shushan1;  LV Xiaoling1
1. Department of Cardiology, 2.Department of Echocardiography, Second Xiangya Hospital of CentralSouth University, Changsha, Hunan 410011, China
关键词:
封堵器; 国产; 房间隔缺损; 经导管治疗; 超声心动描记术
Keywords:
domestic occluder;  atrial septal defect;  transcatheter closure;  echocardiography
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 评价应用国产封堵器治疗继发孔型房间隔缺损（ASD）的初步疗效。方法 31例ASD患者，ASD直径为10~34（19±8）mm。所有患者在X线及经胸超声心动图（TTE）监视下经导管置入国产房间隔封堵器。治疗术后及术后3个月随访超声心动图、胸片、心电图，观察对血流动力学及心功能的影响。结果 全组手术成功率为100%，术后即刻及随访未见残余分流。与术前比较，三尖瓣口、肺动脉瓣口血流峰值明显降低,二尖瓣口血流峰值增加（P<0.05）,术后及随访期右心房、右心室内径缩小，右室射血分数早期下降，后期无明显变化。左室功能无明显变化，无出现新的心律失常和脑栓塞等并发症。结论 国产房间隔封堵器可有效治疗ASD，操作方便，手术成功率高，疗效可靠。有效改善右心高容量负荷状态。
Abstract:
AIM To evaluate the therapeutic effect of transcatheter closure of secundum atrial septal defect (ASD) using domestic septal occluder. METHODS Thirty one patients aged 2 to 64 years were treated with domestic septal occluder through the percutaneous procedure under fluoroscopic and transthoracic echocardiographic minitoring(TTE). The diameters of ASD were 10-34(19±8)mm. Echocardiography, chest X ray and electrocardiography were performed before and after transcatheter closure and during the followup. RESULTS The success rate of the operation was 100%. No residual shunts were found in all the patients right after the procedure and during the followup. The peak blood velocity of tricuspid valves and pulmonary aortic valves was significantly decreased after operation and during the followup (P<0.05), while that of mitral valves was significantly increased (P<0.05). RA and RV diameters were reduced markedly right after the procedure and further decreased during the followup. RVEF was decreased at early stage and remained stable during the followup. LV function was not changed significantly. No complications such as arrhythmia, cerebral embolism occurred. CONCLUSION Domestic septal occluder is suitable for most ASD patients and the operation is simple and effective with good chance of success.

参考文献/References

［1］ 张玉顺，贾国良，刘建平，等. 应用Amplatzer封堵器治疗房间隔缺损疗效评价［J］. 心脏杂志，2001，13(6): 476-478.

［2］ Fischer G, Kramer HH, Stieh J, et al. Transcatheter closure of secundum atrial septal defects with the new selfcentering Amplatzer septal occluder［J］. Eur Heart J, 1999, 20（7）:541-549.

［3］ Podnar T, Martanovic P, Gavora P, et al. Morphological variations of secundumtype atrial septal defects: feasibility for percutaneous closure using Amplatzer septal occluders［J］. Cathet Cardiovasc Intervent, 2001, 53(3): 386-391.

［4］ Fischer G, Stieh J, Uebing A, et al. Experience with transcatheter closure of secundum atrial septal defects using the Amplatzer septal occluder: a single centre study in 236 consecutive patients［J］. Heart, 2003, 89(2): 199-204

［5］ Veldtman GR, Razack V, Siu S, et al. Right ventricular form and function after percutaneous atrial septal defect device closure［J］. J Am Coll Cardiol, 2001, 37(8): 2108-2113.

［6］ 张戈军，戴汝平，刘延玲，等. 房间隔缺损封堵术后心功能的变化［J］. 中华心血管病杂志，2001，29(3): 163-166.

［7］ 张军，姚志勇，田英军，等. 二维超声心动图及组织多普勒检测房间隔缺损封堵术前后右心负荷的变化［J］. 心脏杂志，2004, 16(1): 64-66.

备注/Memo

备注/Memo:
收稿日期：2004-11-07.作者简介：方臻飞，主治医师，博士Tel：(0731)55242222456 Email：zhengfeifang@
更新日期/Last Update: 2010-01-06